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Organization

ADVANCED AUTISM SERVICES VA LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MALKA HERSKO MS CCC SLP (DIRECTOR)
(602) 584-9860
Entity
Organization

Contact information

Practice address
780 LYNNHAVEN PKWY STE 400, VIRGINIA BEACH, VA 23452-7332
(602) 584-9860
(602) 715-1135
Mailing address
36 AIRPORT RD STE 105, LAKEWOOD, NJ 08701-7034

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
106S00000X
Behavior Technician

Other

Enumeration date
05/28/2021
Last updated
06/28/2022
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